Secondary glaucomas often seriously threaten vision and may be very difficult to treat. Extensive research is needed for better understanding of the causes of these glaucomas and for development of better treatments. We propose to continue to carry out clinical studies in correlation with laboratory investigations of disease mechanisms, concentrating on exfoliation glaucoma and pigmentary glaucoma. We will continue the careful clinical studies in which we have begun to define better the natural history of these diseases and to identify prognostic factors, and possibly associated systemic conditions. We will include anterior segment fluorescein angiography, studies of ocular hydrodynamics and tests of responsiveness to anti-glaucoma drugs. In the laboratory, we will perform further studies on the histopathology of specimens of the aqueous outflow system which have been excised during anti-glaucoma surgery and see if clinical findings correlate with the experimental. In experimental animals we wish to determine the influence of exfoliation material and iris pigment particles infused into the anterior chamber on the facility of aqueous outflow, intraocular pressure and the histopathology of the aqueous outflow system. We will also investigate in tissue culture the interactions of these particles with trabecular cells of the human aqueous outflow system. Our ultimate goal is to provide a basis for improving the prospects for treatment in order to prevent or alleviate the glaucomas associated with the exfoliation syndrome and pigment dispersion syndrome.